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The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009 directed GAO to conduct a broad study of homelessness in rural areas. In this report, we provide information about rural homelessness issues, based in significant part on our work in rural areas within six selected states. Specifically, the report addresses the following questions: (1) What are the characteristics of homelessness in rural areas? (2) What assistance is available to individuals or families experiencing homelessness and what amount of funding have the federal departments and agencies awarded to organizations that assist persons experiencing homelessness in rural areas? (3) What barriers do persons experiencing homelessness and homeless service providers encounter when seeking assistance or funding to provide assistance? To address these issues, GAO reviewed relevant literature, conducted site visits, and interviewed agency officials.

Rural homelessness involves a range of living situations but comparing the extent of homelessness in rural and nonrural areas is difficult primarily due to data limitations. Based on GAO visits to six states, persons experiencing homelessness in rural areas could be living in one of a limited number of shelters, in extremely overcrowded situations, in severely substandard housing, or outdoors. While HUD and other agencies collect some data on homeless populations, several challenges exist in using these data to compare the extent of homelessness in rural and nonrural areas. They include difficulties in counting transient populations, limited reporting by service providers in federal data systems, inconsistent reporting across programs, and focusing on the segments of the homeless population that the agency serves. Definitional differences also make comparisons difficult. For instance, the three most common federal definitions of rural use differing criteria such as population or proximity to urban areas. Even within one measure such as population, different agencies can use different parameters and therefore identify different areas as rural. A number of federal programs exist to support those experiencing homelessness in rural areas. Targeted and nontargeted programs fund permanent and emergency housing and supportive services such as mental health services, case management, and job training. However, federal agencies maintain limited data on the amount of homeless assistance awarded to rural areas, making comparisons with assistance awarded to nonrural areas difficult. For instance, HUD maintains some data on the amount of homeless assistance awarded to rural areas through its targeted programs, but the data are based on providers' identification of locations as rural or not. Nontargeted programs can serve persons experiencing homelessness but do not track how much funding is used for homeless assistance. As a result of data limitations such as these, comparisons of funding levels offer limited insight into the relationship between the size of the homeless population in an area and the amount of funding received. Barriers to accessing and providing homeless services in rural areas include limited access to services, large service areas, dispersed populations, and a lack of transportation and affordable housing according to state and local officials and persons experiencing homelessness in the states we visited. For instance, many rural areas have few shelters or shelters with few beds serving very large areas. A program in which HUD provides housing vouchers to homeless veterans and the Department of Veterans Affairs provides clinical and case management services to these same veterans is one of a limited number of examples of formal collaboration and leveraging of federal resources that link housing and supportive services. The effects of limited collaboration may be particularly acute in rural areas because of the barriers cited above. Without a more formal linking of housing and supportive services by HUD and HHS, two of the key agencies for funding these activities, the effectiveness of federal efforts to address homelessness may be diminished. GAO recommends that the Departments of Housing and Urban Development (HUD) and Health and Human Services (HHS) explore further opportunities to strengthen formal collaboration on linking housing and supportive services to address homelessness, with specific consideration for how such collaboration can minimize barriers to service provision in rural areas. HHS and HUD generally agreed with the recommendation.

Recommendations for Executive Action

Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: To strengthen formal collaboration efforts, the Secretary of Housing and Urban Development and the Secretary of Health and Human Services should direct the appropriate program offices to further explore opportunities to more formally link housing and supportive services--in the most appropriate forms and combinations of mainstream and targeted programs identified by both agencies--with specific consideration for how such collaboration could minimize barriers to service provision in rural areas.

Agency Affected: Department of Housing and Urban Development

Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: To strengthen formal collaboration efforts, the Secretary of Housing and Urban Development and the Secretary of Health and Human Services should direct the appropriate program offices to further explore opportunities to more formally link housing and supportive services--in the most appropriate forms and combinations of mainstream and targeted programs identified by both agencies--with specific consideration for how such collaboration could minimize barriers to service provision in rural areas.